• Title/Summary/Keyword: Chronic lower back pain

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Lower Extremity Paralysis Developed during Pain Control in Lung Cancer Patient -A case report- (폐암 환자에서 통증치료중 발생한 하지 마비 -증례 보고-)

  • Kim, Hong-Beum;Song, Pil-Oh
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.439-442
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    • 1996
  • Continuous epidural analgesia has been used widely for chronic pain control, especially in cancer patients. As one of the complications, paraplegia developed during continuous epidural analgesia may be caused by epidural abscess, epidural hematoma, neural damage, chronic adhesive arachnoiditis, anterior spinal artery syndrome, delayed migration of extradural catheter into subdural space or subarachnoid space and preexisting disease. A 55-years-old male with lung cancer was implanted with continuous thoracic epidural catheter for pain control. Twenty days after catheterization, moderate back pain, weakness of lower extremity and urinary difficulty were developed. We suspected epidural abscess at first and made differential diagnosis with MRI which showed metastatic cancer at T2-4 spine, And compressed spinal cord was the main cause of the lower extremity paralysis.

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The Efficacy of Active Exercise Programs for Work-Related Chronic Low Back Pain (직업성 만성요통에 대한 능동적 운동프로그램의 효과)

  • Hur, Jin-Gang
    • Journal of Korean Physical Therapy Science
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    • v.11 no.3
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    • pp.38-48
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    • 2004
  • The purpose of present study is to examine the relative efficacy of active exercise programs for work-related chronic low back pain and to figure out how much they affect mechanical stability of lumbar. Subjects are 43 employees with work-related chronic low hack pain, and they were randomly divided into two groups with general physiotherapy groups and thoracic exercise groups for increasing thoracic mobility. Active exercise programs were done 3 times a week, for 6 months, and the subjects were tested for Pain intensity(VAS), the Oswestry Disability Index, Maximal stretching with both hands in the overhead direction and the lumbar region angle of inclination. All subjects were reassessed with same measurement with Pre-study and 6 months after study After applying active exercise programs, pain intensity didn't show any significant difference between two groups. The Oswestry Disability Index showed significant difference between two groups and thoracic exercise groups decreased significantly compare to general physiotherapy group(p<0.05). Maximal stretching with both hands in the overhead direction showed significant difference between two groups and thoracic exercise group increased significantly more than general physiotherapy groups(p<0.05). The lumbar region angle of inclination showed significant difference between two groups and thoracic exercise group decreased significantly more than general physiotherapy groups (p<0.05). According to the results above, exercise for increasing thoracic mobility has an effect on lumbar stability. For the work-related chronic lower hack pain workers, it is far more effective for lumbar stabilization than general physiotherapy.

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The Comparative Study of Digital Infrared Thermal Image(DITI) on the Patients of Low Back Pain and Normal Group (요통환자와 정상인의 적외선 체열검사 비교 고찰)

  • Kim, Na-Yeon;Choi, Joo-Young;Kang, Jae-Hui;Lee, Hyun
    • Journal of Acupuncture Research
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    • v.27 no.5
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    • pp.89-96
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    • 2010
  • Objectives : This study is designed to evaluate the diagnostic significances of DITI on the patients of low back pain according to impression, symptoms and medical history. Methods : According to impression, symptoms and medical history, thermal changes of $BL_{23}$, $BL_{26}$, $BL_{40}$, $BL_{57}$, $GB_{31}$ and $BL_{60}$ were compared forty-eight low back pain patients and twenty-three normal group. Results : Surface temperature of $BL_{26}$ in case of L-spine HNP is significantly higher than normal group. Surface temperature of $BL_{26}$ in case of low back pain is significantly higher, $GB_{31}$ of radiating pain is significantly lower than normal group. Surface temperature of $BL_{26}$ in case of acute stage is significantly higher, $GB_{31}$ of chronic stage is significantly lower than normal group. Conclusions : Thermal changes of $BL_{26}$ and $GB_{31}$ on the patients of low back pain compared with normal group, according to impression, symptoms and medical history has significances.

Analysis of the characteristics of Patients with Chronic Low Back Pain Using the ICF Concept (ICF 개념을 이용한 만성요통 환자의 특성 분석)

  • Lee, Hae Jung;Song, Ju Min
    • The Journal of Korean Physical Therapy
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    • v.25 no.5
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    • pp.282-287
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    • 2013
  • Purpose: The purpose of this study was to investigate the characteristics of patients with Chronic Low Back Pain (CLBP) in disability, pain, and cognition, and to compare those characteristics to the ICF concept analyzing the association between World Health Organization Disability Assessment Schedule 2.0: 12 item-interviewer version (WHODAS 2.0) and those of scales i.e. Oswestry Disability Index (ODI), the Short-Form McGill Pain Questionnaire (SFMPQ), and the Fear avoidance & belief questionnaire (FABQ). Methods: A total of 91 patients with CLBP were invited to participate in the study. Physical therapists interviewed all participants using SFMPQ, FABQ, ODI, and WHODAS 2.0 for collection of information on pain, cognition, and functional level data. Subjects scored their disability, pain, and cognition related to LBP using WHODAS 2.0, ODI, SFMPQ, and FABQ. Data analysis was performed using the Spearman correlation coefficient. Results: A positive relationship was observed between WHODAS 2.0 and each scale indicating that lower back specific disability components could be related to the ICF concept in ODI (r=0.77). Pain intensity and pain oriented movement were found to be related to general functioning in patients with CLBP (r=0.52, r=0.55, respectively). Conclusion: It can be suggested that the specific disability scale for LBP, ODI can be related to the ICF concept, WHODAS 2.0, and it may be a useful measure for patients with CLBP.

Case Study of Application on ADIM of Patient With Chronic Low Back Pain for Contraction Training of Transversus Abdominis (만성요통환자의 복횡근 수축훈련을 위한 ADIM 적용사례)

  • Kim, Han-Il
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.17 no.2
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    • pp.49-55
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    • 2011
  • Background: The purpose of this study was to identify the effects of the abdominal drawing-in maneuver (ADIM) for contraction training of transversus abdominis (TrA) to the patient with chronic low back pain (CLBP). Methods: A 37-year female patient with CLBP participated in study. This study was fix to method of ADIM that maintain to draw in lower abdomen in sitting position on chair and fix 1 time protocol that perform rest for 1-min and ADIM for 1-min during 10-min. Hereunder the subject performed 2 times protocol during 30-min. Measurement method were visual analogue scale (VAS), Korean version of Oswestry disability index (KODI) and using ultrasound imaging. Results: VAS was decreased 5cm to 1cm after intervention 3 weeks, KODI was decreased 22% to 9% after intervention 3 weeks and changes in thickness of the TrA were increased 32% to 68% during ADIM. Conclusions: These findings suggest that performed the ADIM took effect for decreased pain and functional disability level with increased changes in thickness of the TrA. Therefore, patients with CLBP should be use for training of deep abdominal muscles apply to the ADIM.

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The Effects of Sling and Resistance Exercises on Muscle Activity and Pelvic Rotation Angle During Active Straight Leg Raises and Pain in Patients with Chronic Low Back Pain (만성 허리통증 환자에게 슬링과 기구저항운동이 통증과 능동 뻗은발올림 동안 근활성도, 골반 회전각에 미치는 영향)

  • Kim, Dae-Hyun;Kim, Tae-Ho
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.4
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    • pp.113-121
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    • 2018
  • PURPOSE: This study was conducted to identify a more effective intervention in sling and resistance exercise for chronic low back pain patients. METHODS: Seventy (70) subjects were randomly divided into the sling group (SG) and resistance exercise group (REG). Muscular activity of the internal oblique (IO), external oblique (EO), rectus abdominis (RA), and pelvic rotation angle during active straight leg raise (ASLR), a pressure pain threshold (PPT) and a visual analog scale (VAS) were measured. Sling and resistance exercises were conducted for 12 weeks. Intermediate measurements were taken after 8 weeks and final measurements were taken after 12 weeks. RESULTS: Both groups showed significantly decreased RA muscle activity and significantly increased IO muscle activity (p<.05). Additionally, EO muscle activity was significantly decreased in the REG, but significantly increased in the SG (p<.05), while the pelvic rotation angle and VAS were significantly decreased in the SG (p<.05). The pressure pain threshold was significantly increased in both groups (p<.05). CONCLUSION: Based on the results of this study, a 12-week intervention seems to be effective at improving back pain in both groups. However, a lower VAS was seen in the sling group after 8 weeks of intervention. Therefore, it is recommended that the sling be applied first when establishing a chronic back pain treatment program to shorten the treatment period and reduce the pain period.

Comparison of Difference of the Gluteus Medius Muscle Fiber Thickness during maximum muscle contraction between Chronic Low Back Pain with Gluteus Medius Weakness and Healthy Subject (중둔근 약화를 가진 만성요통환자와 건강한 대상자간 중둔근 최대 근수축 시 근섬유별 두께 비교)

  • Lee, Sang-Wk;Kim, Suhn-Yeop;Yang, Jin-Mo;Park, Seong-Doo
    • Journal of the Korean Society of Physical Medicine
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    • v.10 no.1
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    • pp.71-82
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    • 2015
  • PURPOSE: The aim of this study is to compare changes in the thickness of the gluteus medius muscle fiber between chronic low back pain(clbp) with gluteus medius weakness and healthy subject. METHODS: Ultrasound imaging was used to measure in the thickness of each fiber of the gluteus medius muscle based on maximal muscle contraction during abduction motion of the hip joint in a healthy group (11 subjects) and a chronic CLBP group (21 subjects). An independent t-test was performed to analyze the difference of thickness in each fiber of the gluteus medius muscle and the rate of changes in the fibers in the two groups. RESULTS: The fiber thickness changes in the gluteus medius muscle were significantly lower for the posterior fiber in the CLBP group compared to the healthy group (p<0.01). The changes in rate of difference of thickness the posterior part of the gluteus medius muscle was significantly lower in the CLBP group than in the healthy group (p<0.05). CONCLUSION: The findings of this study CLBP patients with weakness of the gluteus medius muscle that lower for the posterior fiber's difference of thickness and rate of change in the CLBP group compared to the healthy group. Indicate that rehabilitation of CLBP patients with weakness of the gluteus medius muscle should consider the functions of posterior fiber of the gluteus medius muscle.

Serotonin syndrome in a patient with chronic pain taking analgesic drugs mistaken for psychogenic nonepileptic seizure: a case report

  • Boudier-Reveret, Mathieu;Chang, Min Cheol
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.371-373
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    • 2021
  • Serotonin syndrome (SS) is a potentially life-threatening condition that is caused by the administration of drugs that increase serotonergic activity in the central nervous system. We report a case of serotonin syndrome in a patient with chronic pain who was taking analgesic drugs. A 36-year-old female with chronic pain in the lower back and right buttock area had been taking tramadol hydrochloride 187.5 mg, acetaminophen 325 mg, pregabalin 150 mg, duloxetine 60 mg, and triazolam 0.25 mg daily for several months. After amitriptyline 10 mg was added to achieve better pain control, the patient developed SS, which was mistaken for psychogenic nonepileptic seizure. However, her symptoms completely disappeared after discontinuation of the drugs that were thought to trigger SS and subsequent hydration with normal saline. Various drugs that can increase serotonergic activity are being widely prescribed for patients with chronic pain. Clinicians should be aware of the potential for the occurrence of SS when prescribing pain medications to patients with chronic pain.

The Effect of the Lumbar Segmental Mobilization Technique on Chronic Low Back Pain Patients' the Characteristics of the Muscles, and Limited of Stability (허리의 분절적 가동기법이 만성 허리통증 환자의 근육 특성과 안정성 한계에 미치는 영향)

  • Yang, Daejung;Uhm, Yohan
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.4
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    • pp.191-202
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    • 2020
  • Purpose : The purpose of this study is to examine the effect of the segmental mobilization technique of the lower back on the characteristics of the muscles and limited of stability of chronic backache patients. Methods : The subjects of the study were 30 chronic back pain patients who were divided into groups of 15, a manual therapy group (Group I) and a spinal decompression therapy group (Group II), via random assignation. The subjects had 15 minutes of superficial heat therapy, 15 minutes of interference wave therapy, and 5 minutes of ultrasound therapy for conservative physical therapy. Additionally, manual therapy and spinal decompression therapy were administered to each group for 30 minutes, 5 times a week for 8 weeks. Before intervention, the characteristics of the muscles and limited of stability of the muscles were analyzed. After 8 weeks of intervention, the above items were re-measured in the same manner and analyzed between groups. Results : The results of comparative analysis of the characteristics of the muscles and limited of stability between groups showed that there were statistically significant differences. The manual therapy group (Group I) showed significant differences in characteristics of the muscles compared to the spinal decompression therapy group (Group II). The manual therapy group (Group I) showed significant differences in limited of stability compared to the spinal decompression therapy group (Group II). Conclusion : The result confirmed that manual therapy was more effective in the characteristics of the muscles and limited of stability. Based on this study, additional studies are necessary on the effect of various techniques of manual therapy on muscle activity and muscle thickness in chronic back pain patients. In order to develop an effective manual therapy program, studies using a variety of evaluations are needed.

Clinical Experience of Leukemia with Extradural Chloroma during Treatment of Lower Back Pain -A case report- (요통 치료 도중 발견된 경막외강 녹색종을 동반한 백혈병 환자 경험 -증례 보고-)

  • Lim, Kyung-Joon;Oh, Kyoung-Hee;Moon, Hyun-Seok
    • The Korean Journal of Pain
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    • v.13 no.1
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    • pp.119-122
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    • 2000
  • Granulocytic sarcoma (chloroma) is a rare, solid tumor of myelogenous stem cells, shows usually in patients with acute myelogenous leukemia and less commonly in patients with chronic myelogenous leukemia or myeloproliferative disorders. We report here a patient presenting acute paraparesis due to spinal epidural granulocytic sarcoma causing spinal cord compression in acute myelogenous leukemia with a brief review of literature.

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